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Magic Fire Circle: Advanced Hanging Out! |
July 2-5, 2010 |
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Be sure to read the registration information page before filling out this form. To register on-line, click here. |
Name(s)______________________________________________________________
Child(ren)______________________________________________________________
Address______________________________________________________________
City_____________________________ State______________ Zip ______________
Phone: home__________________ work___________________________________
Email:___________________________________ Best time to reach you?__________
| Registration Fee - Adults sliding scale
$150 - $180
Please indicate price chosen. |
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| Adults 18 and up | $ | x____(#adults) | = | $_________(a) |
| 1st Child 14 and under | $ 50 | x____(#child) | = | $_________(b) |
| Additional children under 14 | $ 35 | x____(#children) | = | $_________(c) |
| Teens 15 - 17 | $90 | x____(#teens) | = | $_________(d) |
| Optional Scholarship donation (please help us make the event accessible to everyone!) |
$_________(e) |
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| Total Enclosed: (a thru e) | $_________ | |||
Food preference: ____ dairy; ____ non-dairy (If you leave blank, we count you as dairy)
__ We'd like a cabin space.
Make checks payable to Earth Drum Council.
| Enclosed (check one): | ___ Total due |
| ___ Scholarship application attached |
Earth Drum Council reserves the right to ask any participant to leave the event without a refund if his/her behavior is disruptive to the event. I understand that neither Earth Drum Council nor The Abode of the Message and its management is responsible for personal injury or loss of property during this event.
(signed) ____________________________________ (date) _____________
No registrations will be accepted without signature. Each adult
registering must sign.
To register, please print this form, complete it, and mail it along with your deposit to: EDC, PO Box 1284, Concord, MA 01742
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